Michael Andrew Mills, AMFT

Individual provider Active NPI Marriage & Family Therapist · Loa, UT

NPI 1669818704 · NPPES record last updated May 16, 2013

Key facts

NPI
1669818704
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
8661742-3904 (UT)
Practice address
56 South Main Street
Loa, UT 84747
Phone
(435) 836-2272
NPI assigned
May 16, 2013
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
8661742-3904UTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Outdoor Adventures LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 8661742-3904 UT Yes

Addresses

Primary practice location

56 South Main Street
Loa, UT 84747

Mailing address

PO Box 400
Loa, UT 84747-0400
Phone (435) 836-2272

Other providers in Loa, UT

All providers in Loa, UT · Marriage & Family Therapist in Utah

Sources for this page

Verify at the official NPI Registry.